Lakeland Communications Logo
Residential Local Phone Service Application

Milltown Office
825 Innovation Ave., PO Box 40, Milltown WI, 54858
Phone: 715-825-2171
Luck Office
28 First Ave. West, PO Box 300, Luck WI 54853
Phone: 715-472-2101
Fax Milltown: 715-825-4299
Fax Luck: 715-472-8880
Customer Information
 

Your Name___________

Social Security #___

Company Name________

Service Address_____

City________________

State_______________ ZIP

County______________

Telephone number____

Email address_______
Date you need Service______________
Available Calling Features
Available Calling Features
Calling Features
Main Line
Calling Features
Main Line
Call Waiting
Personal Ringing
Call Forwarding
Call Hold
Call Forward Busy
Caller ID
Call Forward No Answer
Call Return
Three Way Calling
Call Fwd Remote Act
Deactivate Call Waiting
Call Screening
Speed Call 8
Priority Ringing
Speed Call 30
Call Transfer
Call Trace
Pref Call Forward
Voice Mail Res Basic
Voice Mail Res Enhanced
Voice Mail Bus Basic
Voice Mail Bus Enhanced
Do Not Distub w/Pin
Repeat Dialing
Select Call Accept
Warm Line
Voice Data Protection
Code Restriction
Long Distance Options
You must choose a Long Distance Carrier or you will not be able to place long distance calls.
Interlata Carrier:      Intralata Carrier: 

Toll Blocking (Free of Charge):
900 Numbers   Collect Calls   Third Number   Long Distance Blocking   Extended Community Only

Directory Listing (as it should appear in the directory)
Main Directory Listing

Name:_____
Address:____

 Yes - Omit Address from Directory.
Additional Directory Listing: $1.00

Name:_____
Address:____
Directory Information
Published
Unlisted: $1.00
Unlisted/Unpublished: $2.00
Main Phone Line:   YES YES YES
Prepayment
A deposit may be required prior to telephone service being connected for a new access line. An easement is also required. Please leave a number where we may call you with the total prepayment charges due and an arrangement of how payment can be made.
Comments
I/We request telephone service from Lakeland Communications subject to all rules and regulations under which it operates.  I am 18 years of age or older.  I am aware that the Telephone Company will notify the Polk County Department of Health/Social Services at least 5 days prior to scheduled disconnection of telephone service for any reason, if we are requested to do so in writing by the subscriber or other responsible person.


Customer Signature __________________________________

Date __________
 
We will contact you after receiving the application to answer any questions or concerns.